| Quality of Evidence |
| High: Further research very unlikely to change confidence in the estimate of effect. |
| Moderate: Further research likely to have an important impact on confidence in the estimate of effect and may change the estimate. |
| Low: Further research very likely to have an important impact on confidence in the estimate of effect and likely to change the estimate. |
| Very Low: Estimate of the effect very uncertain. |
| Grades of Recommendations |
|---|
| Strong: Desirable effects clearly outweigh undesirable effects or clearly do not. |
| Weak: When tradeoffs are less certain, either because of low quality evidence or because evidence suggests desirable and undesirable effects are closely balanced, weak recommendations become mandatory. |